A snapshot of the Covid-19 pandemic among pregnant women in France
Date
2020Author
Kayem, Gilles
Lecarpentier, Edouard
Deruelle, Philippe
Bretelle, Florence
Azria, Elie
Blanc, Julie
Bohec, Caroline
Bornes, Marie
Ceccaldi, Pierre-François
Chalet, Yasmine
Chauleur, Céline
Cordier, Anne-Gael
Desbrière, Raoul
Doret, Muriel
Dreyfus, Michel
Driessen, Marine
Fermaut, Marion
Gallot, Denis
Garabédian, Charles
Huissoud, Cyril
Luton, Dominique
Morel, Olivier
Perrotin, Franck
Picone, Olivier
Rozenberg, Patrick
Sentilhes, Loïc
Sroussi, Jeremy
Vayssière, Christophe
Verspyck, Eric
Vivanti, Alexandre J.
Winer, Norbert
Alessandrini, Vivien
Schmitz, Thomas
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Abstract
Objective: To describe the course over time of severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) infection in French women from the beginning of the pandemic until mid-April, the risk profile of
women with respiratory complications, and short-term pregnancy outcomes.
Methods: We collected a case series of pregnant womenwith COVID-19 in a research network of 33 French
maternity units between March 1 and April 14, 2020. All cases of SARS-CoV-2 infection confirmed by a
positive result on real-time reverse transcriptase polymerase chain reaction tests of a nasal sample and/
or diagnosed by a computed tomography chest scan were included and analyzed. The primary outcome
measures were COVID-19 requiring oxygen (oxygen therapy or noninvasive ventilation) and critical
COVID-19 (requiring invasive mechanical ventilation or extracorporeal membrane oxygenation, ECMO).
Demographic data, baseline comorbidities, and pregnancy outcomes were also collected.
Results: Active cases of COVID-19 increased exponentially during March 1–31, 2020; the numbers fell
during April 1–14, after lockdown was imposed on March 17. The shape of the curve of active critical COVID-19 mirrored that of all active cases. By April 14, among the 617 pregnant women with COVID-19,
93 women (15.1 %; 95 %CI 12.3–18.1) had required oxygen therapy and 35 others (5.7 %; 95 %CI 4.0–7.8)
had had a critical form of COVID-19. The severity of the disease was associated with age older than 35
years and obesity, as well as preexisting diabetes, previous preeclampsia, and gestational hypertension or
preeclampsia. One woman with critical COVID-19 died (0.2 %; 95 %CI 0 0.9). Among the women who
gave birth, rates of preterm birth in women with non-severe, oxygen-requiring, and critical COVID-19
were 13/123 (10.6 %), 14/29 (48.3 %), and 23/29 (79.3 %) before 37 weeks and 3/123 (2.4 %), 4/29 (13.8 %),
and 14/29 (48.3 %) before 32 weeks, respectively. One neonate (0.5 %; 95 %CI 0.01–2.9) in the critical group
died from prematurity.
Conclusion: COVID-19 can be responsible for significant rates of severe acute, potentially deadly,
respiratory distress syndromes. The most vulnerable pregnant women, those with comorbidities, may
benefit particularly from prevention measures such as a lockdown.
Palabras clave
COVID 19; Respiratory complications; Risk factors; LockdownLink to resource
http://dx.doi.org/10.1016/j.jogoh.2020.101826Collections
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